O believers! Fasting is prescribed for you—as it was for those before you1—so perhaps you will become mindful ˹of Allah˺. ˹Fast a˺ prescribed number of days.1 But whoever of you is ill or on a journey, then ˹let them fast˺ an equal number of days ˹after Ramaḍân˺. For those who can only fast with extreme difficulty,2 compensation can be made by feeding a needy person ˹for every day not fasted˺. But whoever volunteers to give more, it is better for them. And to fast is better for you, if only you knew. Ramaḍân is the month in which the Quran was revealed as a guide for humanity with clear proofs of guidance and the decisive authority. So whoever is present this month, let them fast. But whoever is ill or on a journey, then ˹let them fast˺ an equal number of days ˹after Ramaḍân˺. Allah intends ease for you, not hardship, so that you may complete the prescribed period and proclaim the greatness of Allah for guiding you, and perhaps you will be grateful.
Why Would A Person Partaking In Ramadan Become Hyperglycemic?
Fasting during Ramadan is meant to promote self-discipline and spiritual reflection, but some individuals—especially those with diabetes or insulin resistance—may experience hyperglycemia (high blood sugar levels) while fasting. This can be surprising, as fasting usually lowers blood sugar. However, several factors can lead to unexpected spikes in blood sugar during Ramadan.
Causes of Hyperglycemia While Fasting in Ramadan
1. The Dawn Phenomenon (Fajr Effect)
In the early morning, the body releases stress hormones (cortisol, adrenaline, and glucagon) to prepare for waking up.
These hormones trigger the release of glucose from the liver, which can raise blood sugar levels even before Suhoor.
People with diabetes or insulin resistance may struggle to regulate this glucose increase, leading to high fasting blood sugar levels.
2. Liver Glucose Release (Gluconeogenesis)
During fasting, the body compensates for low food intake by breaking down stored glucose in the liver.
If insulin function is impaired (as in diabetes), the liver may release too much glucose, leading to hyperglycemia despite fasting.
3. Dehydration and Blood Sugar Concentration
Not drinking enough water can lead to reduced blood volume, making glucose more concentrated in the blood.
This is especially common in hot climates or among individuals who sweat a lot while fasting.
4. The Rebound Effect (Somogyi Effect)
If blood sugar drops too low during fasting, the body reacts by producing extra glucose, leading to a rebound high blood sugar level later.
This is common in diabetics taking insulin or blood sugar-lowering medications.
5. Overeating and Poor Food Choices at Iftar
Breaking the fast with sugary or high-carb meals can cause a rapid spike in blood sugar.
Common high-glycemic Iftar foods that worsen hyperglycemia: – Sugary drinks (juices, sodas, sherbets) – Fried foods (samosas, pakoras) – White rice, white bread, and processed carbs – High-sugar desserts (baklava, kunafa, jalebi)
6. Large Portion Sizes at Iftar
After fasting all day, many people overeat at Iftar, leading to a sudden overload of glucose in the bloodstream.
Eating too much too quickly can overwhelm the body’s insulin response, causing post-meal hyperglycemia.
7. Medication Mismanagement
Skipping, delaying, or improperly adjusting diabetes medications can lead to uncontrolled blood sugar levels.
Some people reduce their medication dosage too much to avoid hypoglycemia, leading to high blood sugar instead.
8. Lack of Physical Activity
Reduced movement during fasting hours can slow down glucose metabolism, leading to higher blood sugar levels.
Staying inactive after Iftar can worsen post-meal hyperglycemia.
Who Is Most at Risk of Hyperglycemia During Ramadan?
– People with Type 2 Diabetes (especially if poorly controlled). – Those with insulin resistance (Prediabetes or Metabolic Syndrome). – Diabetics on insulin or blood sugar-lowering medications. – Individuals who consume high-carb or sugary foods at Iftar and Suhoor. – People who are dehydrated or have electrolyte imbalances.
How to Prevent Hyperglycemia While Fasting in Ramadan
1. Stay Hydrated
– Drink 8–10 glasses of water between Iftar and Suhoor. – Avoid caffeinated drinks, which can cause dehydration.
2. Choose Balanced Meals at Suhoor & Iftar
– Eat slow-digesting, fibre-rich foods (whole grains, lentils, vegetables) to prevent blood sugar spikes. – Include lean proteins (chicken, fish, eggs, nuts) to stabilize blood sugar. – Avoid refined carbs and excessive sugars (white bread, sweets, fried foods).
3. Monitor Blood Sugar Levels
– If you have diabetes, check blood sugar before Suhoor, during fasting (if needed), and after Iftar. – If blood sugar rises too high, consult a doctor.
4. Adjust Medication If Necessary
– People with diabetes should consult their doctor before Ramadan to adjust insulin or diabetes medications.
5. Break Your Fast Wisely
– Start with water and 1–2 dates, then eat a light, balanced meal. – Avoid overeating or consuming too many high-carb foods at once.
When to Seek Medical Help
If you experience severe hyperglycemia (blood sugar above 300 mg/dL), seek medical attention if you have: – Excessive thirst & frequent urination. – Extreme fatigue or blurry vision. – Nausea, vomiting, or difficulty breathing (possible ketoacidosis in diabetics).
Conclusion
Hyperglycemia during Ramadan can happen due to hormonal changes, liver glucose release, dehydration, overeating at Iftar, or medication mismanagement. People with diabetes or insulin resistance are most at risk. To prevent high blood sugar, it’s important to stay hydrated, eat balanced meals, monitor blood sugar, and consult a doctor before fasting. If hyperglycemia becomes severe, seek medical help immediately.
FAQs
Why does my blood sugar go up even though I’m fasting?
Your liver may release stored glucose to provide energy, and hormones like cortisol and adrenaline can raise blood sugar levels, especially in the morning.
What foods cause high blood sugar after fasting?
Sugary drinks, white bread, fried foods, and large portions of high-carb meals can cause blood sugar spikes.
How can I prevent hyperglycemia during Ramadan?
Stay hydrated, eat balanced meals at Suhoor and Iftar, monitor blood sugar, and avoid overeating.
Should diabetics fast during Ramadan?
It depends on individual health conditions. Some diabetics can fast safely with medical guidance, but others (especially those with uncontrolled diabetes) may need to avoid fasting.
What should I do if my blood sugar is too high while fasting?
If blood sugar exceeds 300 mg/dL, break your fast, drink water, and consult a doctor if symptoms persist.
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